New method of diagnosing neurogenic dysfunction of bladder in candidates for urinary undiversion. Denervation supersensitivity of urethra to alpha-agonist.

Testing for denervation supersensitivity response of the urethra to alpha-agonist as a means of excluding neurogenic vesical dysfunction prior to planning undiversion is discussed in a case report. The method is specifically applicable to the bladder that has shrunk from disuse or fibrosis and therefore is not amenable to conventional bladder function studies.

Studies on soybean factors which produced goiter in rats.

The goitrogenicities of various preparations obtained from soybean were studied using rats. Thyroid weight, 131I uptake and the ratio of 131I-monoiodotyrosine to 131I-diiodotyrosine of the gland in rats fed the preparation was measured to determine the activity of these preparations. It was resulted that the group of rats receiving the curd had the most hypertrophied thyroid, the enlargement being equal to that in the group of these receiving soybean in the 8 weeks' feeding experiment.

Experience of complete duplication of the collecting system: retrospective analysis of 23 cases with particular emphasis on the type of ureteral hiatus and its implication in the management of duplex.

Twenty-three cases of complete duplication of the collecting system are reviewed. The type of ureteral hiatus was retrospectively studied to assess its relation to various abnormalities of the duplex system. It was stressed that the hiatal concept is quite important in understanding the multifarious problems of the pathophysiology of ureteral dilation, surgical management and faulty embryogenesis of the kidney and ureterovesical junction of the duplex system.

Endoscopic management of urethral stricture.

Experience with transurethral management of urethral stricture using conventional urethroscope and resectroscope of both infant and adult size is reported and the surgical procedure described. Because incision, dilation, and resection of the stricture are done under direct visual control, it is safe and applicable even in severe strictures hitherto untreatable with other refined closed methods.

Intrarenal vascular obstruction of superior ureteropelvic junction causing nephralgia in a woman with complete duplex kidney. (a case of Fraley's syndrome in duplex kidney).

A case of Fraley's syndrome in a Japanese woman was reported. This is believed to be the first case involved in a complete duplex kidney.

Denervation supersensitivity of the urethra to alpha-adrenergics in the chronic neurogenic bladder.

The response of the urethral pressure profile to the administration of various autonomic drugs was compared between a group of eight patients with chronic neurogenic bladder as evidenced by denervation supersensitivity to besacholineR and a group of 10 control subjects. A supersensitive response to the administration of an alpha-stimulant with a rise of maximum urethral pressure of 10 mmHg or more above the control urethral pressure was uniformly observed in the urethra of patients with chronically denervated bladders. Mechanisms of supersensitivity are postulated and the significance of alpha-adrenergic innervation of the urethra are stressed.

Reappraisal of the sympathetic role in the sphincteric urethra. Denervation supersensitivity of the urethra of the chronic neurogenic bladder to alpha-adrenergic drugs.

The response of urethral pressure to administration of an alpha-stimulant was compared between a group of eight patients with chronic neurogenic bladders as evidenced by positive denervation supersensitivity to parasympathomimetic bethanechol chloride and a group of ten control patients. A supersensitive response to administration of an alpha-stimulant with a rise of maximum urethral pressure, 10 mm Hg or more above the control urethral pressure, was uniformly observed in the urethra of patients with chronically denervated bladders. Our results appear to add pharmacologic evidence of alpha-adrenergic predominance over the parasympathetic in the urethra which is believed to be innervated dually in the recently envolving new concept.

A spontaneous vesico-ectopic ureterovaginal fistula in a girl.

A case of a spontaneous vesicovaginal fistula through an ectopic ureteral stump in an 8-year-old Japanese girl is reported. A simple nephrectomy had been done when she was 3 years old. The genesis of this fistula is discussed and the diagnostic significance of vaginoscopy is emphasized.

[Analysis of errors of radiation relay--errors of relay controller using the radiation scaler (author's transl)].

Radiation relay using the radiation scaler acts at the time when the output of the scaler comes to a set value. By this action, the stop valve in infusing line (or exhausting line) is closed and the increment (or decrement) of liquid level of tank is stopped. Same as radiation relay using CR rate meter, switching time of the relay of this system varies statistically due to the statistical property of radioactivity.

Unusual extraperitoneal lesion of the pelvis: cloacal cyst with transitional cell carcinoma.

An unusual cystic tumor of retrovesical space was reported. After puzzling speculation on its histogenesis this extremely rare tumor was concluded to be a cloacal cyst with transitional cell carcinoma. Review of the literature revealed no similar case.

Vesico-ureteral reflux and uninhibited neurogenic bladder.

Ureteral reflux in female patients who also have latent uninhibited neurogenic bladder occurs synchronously with uninhibited contraction, is blocked by buscopan and is aggravated by besacholine. Intrinsic neuromuscular antireflux mechanism of the vesicoureteral junction (VUJ) appears to be affected by unknown ways with uninhibited contraction. Urethrovesical reflux observed synchronously with uninhibited contraction seems to play an additional role in the genesis of urinary infection.

The mechanism of urinary continence after prostatectomy.

An anatomical and neuropharmacological study of the urethra was performed in 19 patients after prostatetectomy to investigate the mechanism of continence. Anatomically, the urethral segment responsible for the postprostatectomy continence was located distal to the open prostatic fossa in the external sphincter which is comprised of intrinsic striated muscle and is called arbitrarily rhabdosphincter by the author. This unique striated muscle in the rhabdosphinecter appears to be primarily under the alpha-adrenergic influence in view of the change in the urethral pressure profile observed following alpha-adrenergic drugs.

[Analysis of errors in radiation relay. (I) Optimum setting of time constant].

The statistical error of liquid level controlled by radiaiton relay is analysed and a method of minimizing the error is proposed in this paper. This method comes to the problem of optimum setting of the time constant of radiation relay. The equations for obtaining the value of time constant are presented and the numerical results are shown in a table and plotted in a figure.

Experience with non-sterile intermittent self-catheterization.

Although a patient subjected to intermittent self-catheterization must carry a catheter and catheterize himself under a non-sterile technique at regular intervals this method is considered the best one available for patients who lead an active social life. When family cooperation is available intermittent catheterization is a cleaner procedure, causes less complications and is easier to manage for a patient confined to bed than the indwelling catheter, cystostomy or other urinary diversion procedures. The technique is also useful for patients with spinal cord injuries, promoting the early return of bladder activity and a life free of the catheter.

Transitional cell carcinoma of renal pelvis in an infant.

A case of transitional cell carcinoma of the renal pelvis in a 4-month-old japanese boy is reported. This patient is the youngest one described in the literature with a tumor of this type. The differential points of Wilms tumor and other types of neonatal renal tumors are discussed.